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Choosing Breast Implant.

Surgical
breast enlargement enables a woman to choose the breast size
that she feels will enhance her body image and
self-confidence. However, some women find that, following
breast augmentation, their ideas about the ideal breast size
have changed, and this can lead them to request additional
surgery. "Additional surgery means additional risks, so
plastic surgeons are always looking for ways to help women
make better choices about breast size at the time of their
initial breast augmentation surgery," says Los Angeles
plastic surgeon Peter Fodor, MD, president of the American
Society for Aesthetic Plastic Surgery (ASAPS).

A recent survey of 1350 breast augmentation patients
showed that, while satisfaction with surgery was extremely
high, nevertheless 34 percent of those who underwent
re-operation did so simply to change the size of their
implants. In most cases, women who change implant size
switch to larger implants, says James Baker, Jr., MD,
co-chair of the ASAPS Breast Surgery Committee and author of
an article on choosing breast implant size that appears in
the current issue of ASAPS' peer-reviewed Aesthetic Surgery
Journal . He warns, however, that implants that are too
large can leave a patient looking "proportionally
disfigured." "If a patient demands a size unsuited to her
body type, I cannot in good conscience perform the surgery,"
he says.

While there are different opinions on selecting the
appropriate implant size, most plastic surgeons agree that
the base diameter of the breast should be the key
measurement determining the selection. "After measuring the
breast's base diameter, I hold a clear plastic template over
the breast to actually show the patient the implant size
that will be most suitable," Dr. Baker explains. "This
allows her to see, for example, how an implant that is too
large simply won't fit under her breast."

Although the average size implant that Dr. Baker uses
today is significantly larger than he used in 1971, when he
began his cosmetic plastic surgery practice, he attributes
the increase to the body type of the patients he sees today.
"Women are now taller with broader chest wall dimensions and
larger frames than they had 30 years ago," he says.

Even though implant size usually is best determined by measurement of the
breasts, patients who are actively involved in the decision about implant size
may be more likely to be satisfied with the results of surgery. How can breast
augmentation patients explore their options for implant size before undergoing
surgery? Here's some advice from the American Society for Aesthetic Plastic
Surgery (ASAPS):

Be frank and open in discussing size so that there is clear
communication, from the beginning, between you and your plastic surgeon.

Select several photographs from magazines illustrating ideal
proportions, and show these to your plastic surgeon as a way to begin the
communication process. The examples should be of individuals with a similar
body type to yours.

Plastic surgeons sometimes have implants in the office that are used for
patients to "try on" different sizes by stuffing them inside their bra. Do
the same thing at home, using plastic bags filled with oatmeal, and see how
various sizes look in different types of clothing.

Maintain realistic objectives and don't assume that bigger is always
better. Implants that are too large not only will upset the aesthetic
balance of your figure, they also may be more prone to sagging and
ultimately give you a "matronly" look. The best approach is to select
implants that will look like a natural part of your body.

"When choosing implant size, patients should be aware that large implants,
compared with smaller sizes, have a greater potential for certain types of
complications, both in the short-term and long-term," says Dr. Fodor. "Patients
who select the smallest implant that will give them a well-proportioned and
natural-appearing body contour are making the best possible choice."

"When choosing implant size, patients should be aware that large implants,
compared with smaller sizes, have a greater potential for certain types of
complications, both in the short-term and long-term," says Dr. Fodor. "Patients
who select the smallest implant that will give them a well-proportioned and
natural-appearing body contour are making the best possible choice.